应用MATLAB快速实现实验对象随机分组

目的:介绍MATLAB实现快速对实验对象随机分组。方法:列举实例详细说明MATLAB实现实验对象随机分组。结果:实例分析表明,应用MATLAB进行实验对象随机分组与文献已报道的方法相比,更简便、快速。结论:应用MATLAB对实验对象进行随机分组操作简单,具有应用价值。     

利用Excel实现对实验对象随机分组的应用

随机化是实验设计应遵循的重要原则之一，旨在通过对实验对象的随机分组，来保证各组实验对象间的均衡性。随机分组有很多常用的方法，如随机数字表法、随机排列表法等。在实验对象较少时，这些方法使用也较为方便；但在实验对象数量较多时，这些手工分组方法不仅繁琐，而且容易出错。随着计算机的广泛应用，引入了通过电脑编号实验对象随机分组的方法。     

用Excel软件进行药物毒理实验的随机分组

目的：借助Excel软件进行随机化分组。方法：利用Excel软件插入随机数字和排序的功能设计随机分组表。结果：采用本法可方便、迅速地将动物以随机数的顺序分配到各处理组中。结论：用Excel软件进行随机化分组简单、快速、准确和方便。     

用快捷键法完成分层随机分组

在农药安全性评价、毒理学等研究中,随机化是一项极为重要的原则,即将研究对象随机分配到实验组和对照组,使每个研究对象都有同等的机会被分配到各组中,以平衡实验组、对照组已知和未知的混杂因素,从而提高各组的可比性,避免造成偏倚[1-4].如何以最少的工作量,完成复杂的随机分组,是每个研究工作者所关心的问题.我们以亚慢性(90 d)经口毒性试验随机分组方法为例,用Excel软件工具菜单中录制宏的方法,建立了亚慢性毒性试验随机分组模板文件,只要打开模板文件,录人大鼠体重,然后按"快捷键",即可得到F检验值和随机分组表.现介绍如下,供同行参考.     

阿奇霉素序贯治疗支原体肺炎的新方法——三阶段疗法

支原体肺炎是小儿的常见病之一，儿科常选用大环内酯类抗生素治疗，疗程需3周以上。阿奇霉素是新一代大环内酯类药物，其疗效好、副作用少，为治疗本病的首选药物之一。因其半衰期较长（40余小时），各药厂的说明书或药物手册多推荐间隔给药方案，即用药3～5d．再停药3～4d，为一疗程。各医院多采用序贯疗法．即先静脉给药1～2周，后改为口服用药1～2周。     

基于疾病诊断相关分组对Ⅰ类切口手术费用消耗指数及时间消耗指数的影响分析

目的:基于疾病诊断相关分组(diagnosis related groups, DRGs)理论对临床Ⅰ类切口手术费用、时间消耗指数进行分析。方法:选取云南省第三人民医院2021年1—12月Ⅰ类切口手术出院患者为研究对象,DRGs分组数据来自医院病案室。采用统计描述方法、费用及时间消耗指数值以1为界限,对Ⅰ类切口手术进行分析。比较同一DRGs组但不同科室的Ⅰ类切口手术病例的住院费用、天数情况。用中位数作为标准,上四分位数加1.5倍四分位间距作为控制上限制定各DRGs组住院费用、天数标准及上限并进行合理性分析。结果:2 253例Ⅰ类切口手术病例分为41组DRGs。费用消耗指数95%散布范围为0.50～1.70,仅有2组不在范围内。时间消耗指数90%散布范围为即0.70～1.50,有4组不在范围内。费用消耗指数>1的DRGs组有31组,时间消耗指数>1的DRGs组有34组。在同一DRGs组中,急诊创伤外科、甲状腺乳腺外科2个科室相较于其他科室住院费用较高、天数较长。根据制定的标准合理性分析后,Ⅰ类切口手术存在超出上限病例的情况,但均在合理范围内。结论:运用DRGs理论可以较直观地...     

三级肿瘤专科医院基于疾病诊断相关分组评价指标应用综合指数法对医疗质量的评价研究

目的 探索三级肿瘤专科医院基于疾病诊断相关分组(DRGs)评价指标应用综合指数法对医疗质量评价的实践及效果,为三级肿瘤专科医院质量管理提供新思路.方法 本研究依托上海联众DRGs数据分析平台结合医院病案首页应用综合指数法,从业务能力、学科水平、疑难诊治程度、医疗服务效率及医疗安全5个维度对医院外科系统、内科系统和放疗系...     

按疾病诊断相关分组视角下控费政策对医疗服务的影响研究

目的探讨按疾病诊断相关分组(DRGs)视角下控费政策对医疗服务的影响。方法以"嘉定区域疾病诊断相关分组医疗服务管理系统"为研究平台,对某二级医院2017—2018年住院患者DRGs相关的DRG组数、病例组合指数值(CMI)、时间消耗指数、费用消耗指数等指标进行比较分析。结果 DRGs组数从390增加到394;总权重从9 198.37增加到9 372.3;CMI从0.76增加到0.83;时间消耗指数从1.05降低到0.98;费用效率指数从1降低到0.93;低风险死亡率由0上升为0.34%;中低风险死亡率由10.16%降低为7.4%;病种难易程度监管指标(RW)≥2例数占本院总例数的比重由1.78%上升到4.43%。结论通过DRGs对控费政策下住院患者的服务能力、服务效率和安全进行评价具有科学、合理和公平的特点,DRGs评价体系也可以成为控费政策下加强医疗服务管理的有效工具。     

“廉价老药”供求不平衡或将长期存在

最近一段时间,有关＂廉价老药＂消失的新闻不断吸引着人们的眼球,各地媒体会不时就此爆出一个个＂被消失＂的老药名字。这类药品常常因价格低廉且上市时间早而被统称为＂廉价老药＂,据有人统计这样的＂廉价老药＂有二三百种。因为经常出现某个品种的市场脱销,甚至＂影响治病救人＂,往往很容易被议论纷纷。＂廉价老药＂为何会消失？有没有什么方法可以破解＂廉价老药＂屡遭消失的宿命？     

基于疾病诊断相关分组的病例组合指数与住院例均药费联动考核机制探索

目的 探讨基于疾病诊断相关分组(DRGs)的病例组合指数(CMI)在例均药费联动绩效考核中的应用价值.方法 提取2018年1月—2021年12月北京友谊医院外科系统临床科室每月的住院例均药费与CMI值.以CMI值为自变量、住院例均药费为因变量绘制散点图,判断并拟合二者间的相关关系.根据各科室CMI值年度变化情况对住院例...     

The clinical pharmacology of ageing

The ageing of populations and individuals continues to be as vital, yet to some extent as neglected, a topic in pharmacology and therapeutics as was first realised about 30 years ago. In parallel with the realisation of the predicted demographic shifts in both the developed and developing world, there have since been major developments in the basic biological concepts of ageing, in the physiology of ageing, in the study of pathogenetic mechanisms underlying a variety of age-associated disorders and syndromes, and in the evidence base for therapeutic intervention in elderly patient populations. These all present new challenges both in the practical delivery of effective medical care and in clinical and biological research. The scale of prescribing for an ageing population has continued to rise as anticipated. Whether there has now been any improvement in the quality or rationality of prescribing, or in the previously demonstrated unacceptable level of susceptibility to adverse drug reactions in the (now expanded) older patient population is largely unknown. We urgently need to find out using up-to-date research methods. National and international guidelines for drug development and regulation have more recently been followed by broader policy initiatives on prescribing for older people, but the impact of these on standards of medication use and on clinical outcome remains to be seen. A new series in this journal on the clinical pharmacology of ageing is timely. The required focus and framework for research have often tended in the past to emerge as afterthoughts behind the merely disease specific, and it is to be hoped that a sequential review of some of the key topics may help to re-ignite a more sound and less short-sighted agenda than previously.     

The clinical pharmacology of tolmesoxide

Summary The haemodynamic response and pharmacokinetics of single dose oral tolmesoxide were studied at various dose levels in 4 patients with severe hypertension. There was a reproducible fall in mean arterial pressure from baseline of 24.2% and a rise in heart rate of 37.6% following administration of tolmesoxide. The onset of antihypertensive action occurred within 1 h, with a peak effect at 3 h after dosing. The mean duration of action was up to 12.0 h. Tolmesoxide had a mean half-life of 3.0 h. It was rapidly absorbed with a mean peak plasma level occurring at 1.0 h. Plasma levels correlated well with the doses administered. Side-effects included mild nausea, facial flushing and postural symptoms.     

The clinical pharmacology of acamprosate

Acamprosate is one of the few medications licensed for prevention of relapse in alcohol dependence, and over time it has proved to be significantly, if moderately, effective, safe and tolerable. Its use is now being extended into other addictions and neurodevelopmental disorders. The mechanism of action of acamprosate has been less clear, but in the decade or more that has elapsed since its licensing, a body of translational evidence has accumulated, in which preclinical findings are replicated in clinical populations. Acamprosate modulates N-methyl-d-aspartic acid receptor transmission and may have indirect effects on γ-aminobutyric acid type A receptor transmission. It is known to decrease brain glutamate and increase β-endorphins in rodents and man. Acamprosate diminishes reinstatement in ethanolized rodents and promotes abstinence in humans. Although acamprosate has been called an anticraving drug, its subjective effects are subtle and relate to diminished arousal, anxiety and insomnia, which parallel preclinical findings of decreased withdrawal symptoms in animals treated with acamprosate. Further understanding of the pharmacology of acamprosate will allow appropriate targeting of therapy in individuals with alcohol dependence and extension of its use to other addictions.     

The clinical pharmacology of salmefamol

1 The absorption, excretion and metabolism of [³H]-salmefamol, a new sympathomimetic bronchodilator drug, have been studied in asthmatic patients.

2 Following oral administration of 1 or 2 mg to four patients the drug was well absorbed, peak plasma levels occurring from 0.6-2.0 h after administration. An improvement in forced expiratory volume in 1 s (FEV₁) (ranging from 12-50% above baseline) was seen.

3 Following aerosol administration of 0.22-0.34 mg to four patients a rapid rise in FEV₁ was seen (range 26-117%). The plasma and urinary pictures following this route were similar to those seen after oral administration, suggesting that the majority of the dose was swallowed.

4 Very little free salmefamol was found in plasma or urine, the majority being present as metabolites. Urinary radioactivity was mainly present in the form of sulphate conjugates of at least two compounds, one of which was salmefamol. The other compound has not been identified but it is suggested that it may be an active metabolite.

     

The clinical pharmacology of viloxazine hydrochloride-a new anti-depressant of novel chemical structure

1 The clinical pharmacological properties of viloxazine hydrochloride (ICI 58,834, Vivalan), a new antidepressant of novel chemical structure, have been investigated in a series of double-blind randomized studies comparing it with placebo and imipramine. Throughout the studies, viloxazine hydrochloride was given in single doses of 100 mg (expressed as base), and imipramine hydrochloride was given in single doses of 50 mg (expressed as salt).

2 The effect of viloxazine upon the following parameters was measured: pulse rate, blood pressure, forced expiratory volume, reaction time, critical flicker frequency, salivary flow, pupil size and palpebral fissure size. In addition, the possible interaction between viloxazine and alcohol was investigated using measurements of reaction time.

3 Both viloxazine and imipramine produced a transient tachycardia, but no consistent effect on blood pressure was seen. Neither drug had any effect upon forced expiratory volume.

4 The differences that emerged between viloxazine and imipramine were that viloxazine depressed critical flicker frequency whereas imipramine did not, and imipramine prolonged reaction time whilst viloxazine did not. Imipramine reduced salivary flow and increased the size of the pupil and palpebral fissure. Viloxazine did neither.

5 Imipramine was shown to potentiate alcohol whereas, at the doses used, viloxazine did not.

6 It is concluded that viloxazine appears to have less anticholinergic and possibly less sympathomimetic properties than imipramine. It is also concluded that viloxazine, unlike imipramine, does not potentiate alcohol.

     

The chemistry,pharmacology and clinical pharmacology of diflunisal

Summary

Studies are reviewed on diflunisal, a new analgesic agent with an improved therapeutic index, compared with acetylsalicylic acid, in animals and humans. Pharmacokinetic data indicate that a twice-daily dosage regimen of diflunisal is adequate for therapeutic purposes. Diflunisal inhibits prostaglandin E synthesis, but in humans at clinically effective doses it does not alter bleeding time or platelet aggregation. Diflunisal is uricosuric at clinically effective doses. No clinically important drug interactions with diflunisal have been found to date, although some slight alterations in blood and urine drug levels have been noted. The slight increase in prothrombin time seen when diflunisal and acenocoumarol were co-administered is not considered to be of major clinical importance.     

药物致突变性的聚类分析

若n种药物各进行m项致突变试验,构成论域U。以模糊数学聚类分析的方法,可将论域U中n种 X_(11) X_(12) … X_1m U= X_(21) X_(22) … X_2m Xn_1 Xn_2 … Xnm药物按其致突变性的相似性划分为不同类群,据此建立了评价药物致突变性的数学模型。该模型既考虑了致突变试验中各项结果,又考虑了给药剂量对致突变试验结果的影响。使采用不同的控制标准控制不同用途的药物成为可能。并可减少人为因素的影响。